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CHARLESTON, W.Va. | Equal parts graceful and eerie, massive brick and stone asylums once loomed over towns from Maine to California as the 19th century’s ideal for the humane treatment of the mentally ill.

Ornate facades, turrets, sprawling grounds and sheer palatial size belied the name mental hospital. Known as Kirkbride buildings, for the Pennsylvania physician who inspired them, they flourished for half a century.

Today, the forces of age and neglect, together with a century of changes in treating mental illness, have slashed the ranks of Kirkbride asylums to a handful that will need ambitious developers to save them from collapse.

Many of the surviving buildings are on the National Register of Historic Places, but restoring them is not easy. The colossal structures face a slow demolition by decay because of the enormous cost of maintenance, let alone renovation.

Greystone Park Psychiatric Hospital in Parsippany, N.J., is a prime example. The 132-year-old neo-Gothic building was the largest poured-concrete structure in the U.S. before the Pentagon was built.

Many people - from preservationists to developers to elected officials - want to see it saved, but keep hitting the same wall.

“Ultimately, it comes down to money,” said Carrie Fellows, the director of the Morris County Heritage Commission. “It would take unfathomable millions. Multiple millions and millions of dollars.”

That’s the problem for communities grappling with the physical legacy of Dr. Thomas Kirkbride, who at one time influenced the construction of nearly every mental hospital in the country.

Kirkbride in 1854 proposed a model for asylums: campuses sprawled over hundreds of acres where patients would live in self-contained communities, with the centerpiece a beautiful, enormous building that Kirkbride wanted to resemble the finest hotels of the time.

“The building became part of the treatment,” said Nancy Tomes, chairwoman of the Stony Brook University history department and the author of “The Art of Asylum-Keeping,” about the Kirkbride model. “The idea was to design a building that would actually help your mind recover.”

That approach lost favor in the 20th century, and after World War II, a series of court decisions and the development of psychiatric medications led to the closure of asylums around the country.

Neighboring communities were left to ponder whether to find some new use for the massive structures or raze them.

In dozens of places, the answer was the bulldozer. The buildings were either too dilapidated or there was no money for restoration. From the hundreds of Kirkbride hospitals that once existed, about 30 are left in 20 states, in conditions from developed to derelict.

Even those in need of costly repairs, though, can inspire a certain swashbuckling optimism.

Last year, Morgantown asbestos contractor Joe Jordan bought the former Weston State Hospital in northern West Virginia, which at 242,000 square feet is one of the largest hand-cut sandstone buildings in the world.

Mr. Jordan gave the property one of its earlier names, the Trans-Allegheny Lunatic Asylum, and opened part of it to tours and other events to raise money for its restoration.

The goal is to turn the asylum into a hotel, along the lines of a former Kirkbride facility in Traverse City, Mich., said Mr. Jordan’s daughter, Rebecca Jordan-Gleason.

It won’t be easy. Repairing the roof will cost about $5 million, and Mrs. Jordan-Gleason said it took three months just to clean the portion of the hospital now open to tours.

The attempts to raise money for the restoration have also met protests from some mental health advocates, who say ghost tours and the loaded word “lunatic” are offensive to former patients.

“It’s hard, but at the end of the day, when you walk around to the front of the building and look up at it, you remember why you’re doing this,” Mrs. Jordan-Gleason said.

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